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Structure of wet specimens in electron microscopy. Improved environmental chambers make it possible to examine wet specimens easily.

Several recent technological advances have increased the practicality and usefulness of the technique of electron microscopy of wet objects. (i) There have been gains in the effective penetration of high-voltage microscopes, scanning transmission microscopes, and high-voltage scanning microscopes. The extra effective penetration gives more scope for obtaining good images through film windows, gas, and liquid layers. (ii) Improved methods of obtaining contrast are available (especially dark field and inelastic filtering) that often make it possible to obtain sufficient contrast with wet unstained objects. (iii) Improved environmental chamber design makes it possible to insert and examine wet specimens as easily as dry specimens. The ultimate achievable resolution for wet objects in an environmental chamber will gradually become clear experimentally. Resolution is mainly a function of gas path, liquid and wet specimen thickness, specimen stage stability, acceleration voltage, and image mode (fixed or scanning beam) (13). Much depends on the development of the technique for controlling the thickness of extraneous water film around wet objects or the technique for depositing wet objects onto dry, hydrophobic support films. Although some loss of resolution due to water or gas scattering will always occur, an effective gain is anticipated in preserving the shape of individual molecules and preventing the partial collapse that usually occurs on drying or negative staining. The most basic question for biological electron microscopy is probably whether any living functions of cells can be observed so that the capabilities of the phase contrast and interference light microscopes can be extended. Investigators are now rapidly approaching a final answer to this question. The two limiting factors are (i) maintaining cell motility in spread cells immersed in thin layers of media and (ii) reducing beam radiation damage to an acceptable level. The use of sensitive emulsions and image intensifiers can bring the observation dose below that required to stop cell motility. Use of a timed, pulsed deflector system enables sufficiently short exposures to be obtained to eliminate blurring due to Brownian motion. Environmental chambers have enhanced the possibilities of electron diffraction analysis of minute crystals and ordered biological structures. High-resolution electron diffraction patterns (especially kinematic) of protein crystals can only be obtained in a wet environment. Hence, it may now be possible to obtain undistorted images of protein molecules. Moreover, by subjecting diffraction patterns to image-iterative techniques (56), it will be possible to phase the electron diffraction patterns to give a calculated image with a higher resolution than that which can be produced by electron microscope objective lenses. Environmental chambers offer exciting prospects for the determination of water structure and water and ice nucleation (atmospheric science). Nucleation data near the molecular level have been badly needed for some time. The application of environmental chambers in industrial chemistry, for example, in studies of polymerization, catalysis, and corrosion, are awaiting exploration. They offer an unusual approach to measurements of reaction kinetics through images that should be both sensitive and rapid.

Animals↗

Concurrent analysis of nose and groin swab specimens by the IDI-MRSA PCR assay is comparable to analysis by individual-specimen PCR and routine culture assays for detection of colonization by methicillin-resistant Staphylococcus aureus.

The IDI-MRSA assay (Infectio Diagnostic, Inc., Sainte-Foy, Quebec, Canada) with the Smart Cycler II rapid DNA amplification system (Cepheid, Sunnyvale, CA) appears to be sensitive and specific for the rapid detection of nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). We assessed the sensitivity and specificity of this assay under conditions in which both the nose and cutaneous groin specimens were analyzed together and compared the accuracy of this PCR approach to that when these specimens were tested separately and by culture assays in an inpatient population with known high rates (12 to 15%) of MRSA colonization. Of 211 patients screened, 192 had results assessable by all three methods (agar-broth culture, separate nose and groin IDI-MRSA assay, and combined nose-groin IDI-MRSA assay), with MRSA carriage noted in 31/192 (16.1%), 41/192 (21.4%), and 36/192 (18.8%) patients by each method, respectively. Compared to agar culture results, the sensitivity and specificity of the combined nose-groin IDI-MRSA assay were 88.0% and 91.6%, respectively, whereas when each specimen was processed separately, the sensitivities were 90.0% (nose) and 83.3% (groin) and the specificities were 91.7% (nose) and 90.2% (groin). IDI-MRSA assay of a combined nose-groin specimen appears to have an accuracy similar to that of the current recommended PCR protocol, providing results in a clinically useful time frame, and may represent a more cost-effective approach to using this assay for screening for MRSA colonization.

Groin↗

Cytology of angiosarcoma. Findings in fourteen fine-needle aspiration biopsy specimens and one pleural fluid specimen.

We report the cytologic features of 15 cases of angiosarcoma from various sites and include 14 fine-needle aspiration (FNA) biopsy specimens and 1 pleural fluid specimen. Six were initial diagnoses with histologic confirmation; an additional case in the liver was an initial diagnosis without tissue confirmation. One case represented lymph node metastasis from a primary prostatic epithelioid angiosarcoma. In 10 cases, immunohistochemical staining for factor VIII-related antigen, CD34, CD31, or Ulex europaeus agglutinin I was performed on the cytology or histology specimen. The aspirates varied in cellularity, and the degree of nuclear atypia ranged from relatively bland in a case of low-grade angiosarcoma of the prostate to highly pleomorphic in a lymph node metastasis from a facial cutaneous angiosarcoma. Vasoformative features such as intracellular RBCs, well-formed vessels, attempts at microacinar/lumen formation, and intracytoplasmic lumens were variably present. The background was bloody in all specimens, with necrosis in rare cases. This cytologic series emphasizes that the cytologic features are heterogeneous but that the diagnosis can be suggested by fine-needle aspiration (FNA) when vasoformative features are present. The diagnosis can be made conclusively by FNA with immunocytochemical confirmation of endothelial differentiation.

Aged↗

Low bias in assayed values of lipoprotein antigens--lipoprotein(a) and apolipoproteins A-I and B--in midday postprandial blood specimens compared with morning fasting specimens.

Two-hour postprandial specimens have a -14% proportional bias for lipoprotein(a) [Lp(a)], a -0.035 g/L systematic bias for apolipoprotein (apo) A-I, and a -9% proportional bias for apo B, compared with values in 12-h fasting specimens. Although a physiological hemodilution appears to account for a portion of these biases, other major factors must be implicated for Lp(a) and apo B. Even after dilutional effects are controlled for, assayed values of Lp(a) are 11-13% lower, and assayed values of apo B are 8-9% lower, in postprandial specimens than in fasting specimens. Therefore, the time of collection of a blood sample relative to the last meal can significantly affect assayed values of lipoprotein antigens. Further studies are needed to determine whether these observations result from a physiological sequestering of lipoproteins in the postprandial state or from negative interferences affecting the assays of lipoprotein antigens.

Apolipoprotein A-I↗

Sporadic Cajal cell hyperplasia is common in resection specimens for distal oesophageal carcinoma. A retrospective review of 77 consecutive surgical resection specimens.

Interstitial cell of Cajal (ICC) hyperplasia has been documented in conditions associated with multiple gastrointestinal stromal tumours (GISTs) (familial GIST syndromes, Carney's triad and von Recklinghausen's disease) and rarely in the vicinity of sporadic GISTs. The incidence of sporadic ICC hyperplasia and the so-called seedling leiomyoma (SLM) of the lower oesophagus has not been studied in the KIT era. In a retrospective review of 77 consecutive, routinely processed oesophagogastric resection specimens for distal oesophageal carcinoma, we found foci of ICC hyperplasia in 7 of 77 (9.1%) cases and foci of SLM in 17 of 77 (22%) cases. Two types of ICC hyperplasia were recognized: a non-circumscribed type and a nodular expansile type with peripherally compressed myenteric neural tissues. All cases of ICC hyperplasia were vimentin+/CD34+/CD117+. SLMs were desmin+/vimentin(-)/CD34(-)/CD117(-), similar to smooth muscles of the gut wall. In a prospective study of 32 non-carcinomatous specimens from age-matched patients (mostly autopsy cases), we found SLMs in only one case, but we were unable to detect ICC hyperplasia in any of the cases. We concluded that sporadic KIT-positive spindle-cell hyperplasia and SLMs were unexpectedly common in distal oesophageal specimens harbouring carcinomas. The possible mechanisms leading to the development of these putative precursor lesions will be discussed.

Adenocarcinoma↗

Application of an automated specimen search system installed in a transmission electron microscope for the detection of caliciviruses in clinical specimens.

To evaluate the performance of an automated specimen search system in the detection of caliciviruses such as Norwalk-like viruses and Sapporo-like viruses, a suitable negative staining method was developed and the viruses were examined using the system installed in a transmission electron microscope (TEM). Clear images of the viruses were obtained by staining with 2% uranyl acetate at pH 4.0 as compared with 2% phosphotungstic acid staining at any pH. When the image parameter of 30+/-6 nm for the diameter of a single virus-like particle of 2% uranyl-acetate-stained Norwalk-like virus was set on the automated specimen search system, 95% of the virus-like particles that were counted by the conventional TEM technique were detected. The system was used to detect Norwalk-like viruses in five semipurified stool samples in which Norwalk-like viruses had already been detected by reverse transcription-polymerase chain reaction assay and conventional electron microscopy. The positive detection rate for Norwalk-like viruses, which had been counted by the conventional technique, ranged from 56.2 to 77.9% using this system. Our findings indicate that the automated specimen search system installed in a TEM is suitable for the detection of caliciviruses in semipurified stool samples. The system is useful for clinical diagnosis without the need for operator intervention.

Automation↗

Resection specimen analysis of proximal tibial anatomy based on 100 total knee arthroplasty specimens.

Although it is known that there is some asymmetry of the tibial plateau, most total knee arthroplasty designs currently have a symmetric tibial component. Using resection specimen analysis of the tibial plateau from 100 total knee arthroplasty specimens, the authors have examined the tibial plateau to further delineate, quantitatively, the medial and lateral tibial configuration. Unmagnified radiographs of each of the specimens were produced. A line was drawn along the mediolateral axis. The midpoint and points 10, 20, and 30% from the medial and lateral peripheries were then calculated. The average anteroposterior medial 10, 20, and 30% dimensions were 3.79, 4.74, and 5.06 cm, respectively. The average anteroposterior lateral 10, 20, and 30% dimensions were 3.48, 4.10, and 4.16 cm, respectively. The ratios of the lateral/medial anteroposterior distances at 10, 20, and 30% from the periphery were 92.10, 86.77, and 82.46%, respectively. A total knee arthroplasty system that recognizes the difference in the medial and lateral tibial plateaus and designs a prosthesis to account for the smaller, lateral tibial plateau may achieve the goal of maximizing tibial coverage as well as eliminate the problems associated with a symmetric design.

Arthritis, Rheumatoid↗

Utility of Aspergillus antigen detection in specimens other than serum specimens.

The detection of circulating galactomannan in serum is an important tool for the early diagnosis of invasive aspergillosis. A commercial enzyme-linked immunosorbent assay (Platelia Aspergillus; BioRad) was shown to be both highly sensitive and specific for detection of galactomannan in serum samples. Despite the fact that this assay is validated for serum samples, specimens of other body fluids are increasingly used for detection of galactomannan, including urine, bronchoalveolar lavage fluid, and cerebrospinal fluid. Review of the literature shows that galactomannan can be detected in each of these samples from patients with invasive aspergillosis with higher sensitivity than is the case with culture, as well as early in the course of infection. However, the evidence thus far is based on case reports--predominantly retrospective studies--that often include heterogeneous patient populations and limited numbers of cases of proven infection. Clearly, well-designed prospective studies with systematic sampling and use of consensus case definitions are needed to compare the performance of antigen detection in samples other than serum specimens with that in serum specimens.

Antigens, Fungal↗

Detection of allele loss on chromosome 16q in DNA isolated from fine needle aspiration specimens of breast tumors. A simulation study using surgically resected specimens.

OBJECTIVE: To clarify whether analysis of loss of heterozygosity (LOH) on chromosome 16q is possible using DNA isolated from fine needle aspiration specimens, a simulation study was performed using resected biopsy or mastectomy specimens of 37 breast carcinomas and 3 fibroadenomas. STUDY DESIGN: A highly polymorphic (AC)n repeat region on the D16S305 locus on chromosome 16q24 was amplified in the DNA samples by the polymerase chain reaction (PCR) using 32P-labeled oligonucleotide primers, and the PCR products were electrophoresed in denaturing gel for detection of LOH by autoradiography. RESULTS: PCR was successful in 34 cases, and LOH was detected in 10 (71%) of 14 carcinomas but not in the 3 fibroadenomas. These results were almost always compatible with the data obtained by restriction fragment length polymorphism analysis on chromosome 16q using Southern blotting. CONCLUSION: Examination of LOH on 16q by (AC)n polymorphism analysis using fine needle aspiration specimens is suggested as a supportive tool for preoperative diagnosis of breast tumors.

Adult↗

[Analysis of the effects of physico-chemical factors on the stability of lead and mercury levels in biological specimens. I. Biological specimens with the addition of Pb and Hg standards].

For the analysis of the process of precipitation and adsorption in the walls of polyethylene and glass vessels in which biological specimens containing mercury and lead were stored, the techniques of scanning electrone microscopy and X-ray microanalysis were applied. It was observed that the losses of: --lead in stored urine specimens were mainly due to precipitation, --mercury in stored urine specimens occur, among others, through adsorption on vessels' walls. X-ray microanalysis may also facilitate determination of the chemical composition of micro-structural fragments deposited on the surface of vessels.

Adhesiveness↗

The Great Lakes Fisheries Specimen Bank: a Canadian perspective in environmental specimen banking.

Since 1977 the Canadian Department of Fisheries and Oceans (DFO) has maintained a specimen bank for retrospective chemical analyses. The Great Lakes Fisheries Specimen Bank (GLFSB) is a complementary activity to the department's ongoing Great Lakes Contaminants Surveillance Program that has annually, since 1977, monitored levels of metals and organochlorines in aquatic biota throughout the Canadian Great Lakes. Past activities have focused on defining the effects of long-term frozen storage on the integrity of organochlorine residues in archived biological tissues. Archived samples have been reanalyzed for total PCBs, PCB congeners including co-planar PCBs, dioxin and furan isomers, and 22 toxaphene congeners. More recently, archived samples of predatory fish have been analyzed for stable isotopes of nitrogen (delta 15N) and carbon (delta 13C), as indicators of historical changes in food web dynamics. A catalogue or user-guide has recently been completed describing all information associated with samples stored in the GLFSB.

Animals↗

The relationship between the Canadian Wildlife Service Specimen Bank and the Wildlife Toxicology Program: the effect on specimen collection.

A general description of the Canadian Wildlife Service Specimen Bank is given. Eighty percent of the 55000 specimens stored are wild bird tissues. Tissues are collected as part of the Wildlife Toxicology Program and subjected to chemical and biochemical testing. Tissues are stored at various freezing temperatures i.e. -40 degrees C, -85 degrees C or in the gaseous phase over liquid nitrogen, depending on the intended analytical work to be done.

Animals↗

Recommendation for the examination of pancreaticoduodenectomy specimens removed from patients with carcinoma of the exocrine pancreas. A proposal for a standardized pathological staging of pancreaticoduodenectomy specimens including a checklist.

The prognosis of ductal adenocarcinoma of the pancreas is poor. Despite many attempts at a more aggressive surgical approach, tumor recurrence rates of around 80% are common. For various reasons, most of the studies on the subject are difficult to compare. Not only do the surgical techniques vary, but, more importantly, the methods used for processing the specimens and for the pathological examination differ. If we are to improve the situation, it would appear imperative to standardize procedures. Standardized pathological staging of pancreaticoduodenectomy specimens should be performed mainly with reference to the guidelines of the WHO and UICC, with optional staging of the lymph nodes according to their anatomical site. Precise definition and accurate examination of the resection margins, especially of that towards the retroperitoneum, is essential for a better comparison of the results of the different therapeutic strategies and approaches to pancreatic carcinoma.

Adenocarcinoma↗

[Bronchoscopic specimen collection, role of the protected specimen brush in lower respiratory tract infections].

INTRODUCTION: The ineffectiveness of microbiological methods in the lower respiratory tract infections are caused by anachronistic sampling methods. Authors checked the protected specimen brush effectiveness and those of the influencing factors. MATERIALS AND METHODS: 103 patients were involved in the study. The causative agents were identified in 44 cases. These results were compared to last year's classic sampling techniques and they experienced 20.4% improvement of the sensitivity. Further increasing in effectiveness can be reached if we perform bacteriological sampling after the first unsuccessful antibiotic treatment was performed. Out of 103 examined patients only 69 underwent antibiotic treatment. In the case of 13 patients after the course of one type antibiotic treatment 10 positive bacteriological cultures were positive. In the case of 31 patients 2 types of antibiotics were administered sequentially and examined afterwards and the authors found 15 positive bacteriological cultures. In the case of 25 patients the administered sequentially 3 times of antibiotics and examined afterwards, 6 cultures were positive. CONCLUSION: The examinations prove that the protected specimen brush, used in time, raises the sensitivity of microbiological processes.

Adult↗

A sensitive enzyme-linked immunosorbent assay used to differentiate type AB specimen from a mixture of type A and type B specimens.

A sensitive enzyme-linked immunosorbent assay (ELISA) for detection of ABO blood substances in human body fluids was devised. The ELISA plates coated with purified human anti-A or anti-B serum effectively captured the blood substances, and these were then analysed by the combination of rabbit anti-A and goat anti-B. This capture ELISA could differentiate the type AB specimen from a mixture of the type A and the type B specimens, and the method was applied to rape cases to make the ABO typing of the criminal.

ABO Blood-Group System↗

Prognostic significance of DNA ploidy in oral squamous cell carcinomas. A retrospective flow and image cytometric study with comparison of DNA ploidy in excisional biopsy specimens and resection specimens, primary, tumors, and lymph node metastases.

Deoxyribonucleic acid ploidy was determined in paraffin-embedded tumor tissue from 116 patients with primary oral squamous cell carcinomas (including 5 carcinomas of the lip and 14 of the tongue) by means of flow cytometry. One hundred six cases were suitable for evaluation (91%). Sixty-eight percent of the cases (n = 72) showed a nondiploid nuclear DNA content. Nondiploidy correlated significantly with presence of lymph node metastases (p < 0.02) but not with tumor stage, grading (World Health Organization), or relapse-free and overall survival. Carcinomas of the lip and tongue turned out to be diploid more frequently than other oral squamous cell carcinomas (p = 0.002). In the 21 cases in which a comparison of DNA content of excisional biopsy specimens and subsequent resection specimens was possible a difference in DNA ploidy was found in one case only. The comparison of primary tumors and their lymph node metastases in 30 cases revealed a discrepancy of DNA content in five cases (17%), which was connected with a shift from nondiploidy to diploidy in four out of five cases. Fifty cases studied in parallel by means of image cytometry with Feulgen-stained tissue sections exhibited a concordance of the ploidy status in 87% and a significant correlation of the DNA index values obtained with both methods (p < 0.01). These results demonstrate that DNA ploidy in oral squamous cell carcinomas is distributed rather homogeneously within the tumors and remains rather stable in the lymph node metastases. Despite a significant correlation between nondiploidy and presence of lymph node metastases, ploidy failed to be a statistically significant parameter for prognosis in oral squamous cell carcinomas in our investigation.

Aneuploidy↗

Quantification of human gastric G cell density in endoscopic biopsy specimens: effect of shape of specimen.

Experiments performed on endoscopic biopsy specimens show that when they are curved, as they often are, the inner surface of the mucosa is contracted and the outer surface is expanded. When estimating G cell numbers per unit length of mucosa from such biopsy specimens, artefacts produced by variations in shape are minimised by relating the number of G cells to the mean of the length of the muscularis mucosae and the length of the outer mucosal profile on the tissue section containing these cells.

Biopsy↗